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Metallic Stent Placement in Hemodialysis Graft Patients after Insufficient Balloon Dilation

OBJECTIVE: We wanted to report our experience of metallic stent placement after insufficient balloon dilation in graft hemodialysis patients. MATERIALS AND METHODS: Twenty-three patients (13 loop grafts in the forearm and 10 straight grafts in the upper arm) underwent metallic stent placement due to...

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Autores principales: Liang, Huei-Lung, Pan, Huay-Ben, Lin, Yih-Huie, Chen, Chiung-Yu, Chung, Hsiao-Min, Wu, Tung-Ho, Chou, Kang-Ju, Lai, Pin-Hong, Yang, Chien-Fang
Formato: Texto
Lenguaje:English
Publicado: The Korean Radiological Society 2006
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2667584/
https://www.ncbi.nlm.nih.gov/pubmed/16799272
http://dx.doi.org/10.3348/kjr.2006.7.2.118
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author Liang, Huei-Lung
Pan, Huay-Ben
Lin, Yih-Huie
Chen, Chiung-Yu
Chung, Hsiao-Min
Wu, Tung-Ho
Chou, Kang-Ju
Lai, Pin-Hong
Yang, Chien-Fang
author_facet Liang, Huei-Lung
Pan, Huay-Ben
Lin, Yih-Huie
Chen, Chiung-Yu
Chung, Hsiao-Min
Wu, Tung-Ho
Chou, Kang-Ju
Lai, Pin-Hong
Yang, Chien-Fang
author_sort Liang, Huei-Lung
collection PubMed
description OBJECTIVE: We wanted to report our experience of metallic stent placement after insufficient balloon dilation in graft hemodialysis patients. MATERIALS AND METHODS: Twenty-three patients (13 loop grafts in the forearm and 10 straight grafts in the upper arm) underwent metallic stent placement due to insufficient flow after urokinase thrombolysis and balloon dilation. The indications for metallic stent deployment included 1) recoil and/or kinked venous stenosis in 21 patients (venous anastomosis: 17 patients, peripheral outflow vein: four patients); and 2) major vascular rupture in two patients. Metallic stents 8-10mm in diameter and 40-80 mm in length were used. Of them, eight stents were deployed across the elbow crease. Access patency was determined by clinical follow-up and the overall rates were calculated by Kaplan-Meier survival analysis. RESULTS: No procedure-related complications (stent fracture or central migration) were encountered except for a delayed Wallstent shortening/migration at the venous anastomosis, which resulted in early access failure. The overall primary and secondary patency rates (±standard error) of all the vascular accesses in our 23 patients at 3, 6, 12 and 24 months were 69%±9 and 88%±6, 41%±10 and 88%±6, 30%±10 and 77%±10, and 12%±8 and 61%±13, respectively. For the forearm and upper-arm grafts, the primary and secondary patency rates were 51%±16 and 86%±13 vs 45%±15 and 73%±13 at 6 months, and 25%±15 and 71%±17 vs 23%±17 and 73%±13 at 12 months (p = .346 and .224), respectively. CONCLUSION: Metallic stent placement is a safe and effective means for treating peripheral venous lesions in dialysis graft patients after insufficient balloon dilation. No statistically difference in the patency rates between the forearm and upper-arm patient groups was seen.
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spelling pubmed-26675842009-04-22 Metallic Stent Placement in Hemodialysis Graft Patients after Insufficient Balloon Dilation Liang, Huei-Lung Pan, Huay-Ben Lin, Yih-Huie Chen, Chiung-Yu Chung, Hsiao-Min Wu, Tung-Ho Chou, Kang-Ju Lai, Pin-Hong Yang, Chien-Fang Korean J Radiol Original Article OBJECTIVE: We wanted to report our experience of metallic stent placement after insufficient balloon dilation in graft hemodialysis patients. MATERIALS AND METHODS: Twenty-three patients (13 loop grafts in the forearm and 10 straight grafts in the upper arm) underwent metallic stent placement due to insufficient flow after urokinase thrombolysis and balloon dilation. The indications for metallic stent deployment included 1) recoil and/or kinked venous stenosis in 21 patients (venous anastomosis: 17 patients, peripheral outflow vein: four patients); and 2) major vascular rupture in two patients. Metallic stents 8-10mm in diameter and 40-80 mm in length were used. Of them, eight stents were deployed across the elbow crease. Access patency was determined by clinical follow-up and the overall rates were calculated by Kaplan-Meier survival analysis. RESULTS: No procedure-related complications (stent fracture or central migration) were encountered except for a delayed Wallstent shortening/migration at the venous anastomosis, which resulted in early access failure. The overall primary and secondary patency rates (±standard error) of all the vascular accesses in our 23 patients at 3, 6, 12 and 24 months were 69%±9 and 88%±6, 41%±10 and 88%±6, 30%±10 and 77%±10, and 12%±8 and 61%±13, respectively. For the forearm and upper-arm grafts, the primary and secondary patency rates were 51%±16 and 86%±13 vs 45%±15 and 73%±13 at 6 months, and 25%±15 and 71%±17 vs 23%±17 and 73%±13 at 12 months (p = .346 and .224), respectively. CONCLUSION: Metallic stent placement is a safe and effective means for treating peripheral venous lesions in dialysis graft patients after insufficient balloon dilation. No statistically difference in the patency rates between the forearm and upper-arm patient groups was seen. The Korean Radiological Society 2006 2006-06-30 /pmc/articles/PMC2667584/ /pubmed/16799272 http://dx.doi.org/10.3348/kjr.2006.7.2.118 Text en Copyright © 2006 The Korean Radiological Society http://creativecommons.org/licenses/by-nc/3.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Liang, Huei-Lung
Pan, Huay-Ben
Lin, Yih-Huie
Chen, Chiung-Yu
Chung, Hsiao-Min
Wu, Tung-Ho
Chou, Kang-Ju
Lai, Pin-Hong
Yang, Chien-Fang
Metallic Stent Placement in Hemodialysis Graft Patients after Insufficient Balloon Dilation
title Metallic Stent Placement in Hemodialysis Graft Patients after Insufficient Balloon Dilation
title_full Metallic Stent Placement in Hemodialysis Graft Patients after Insufficient Balloon Dilation
title_fullStr Metallic Stent Placement in Hemodialysis Graft Patients after Insufficient Balloon Dilation
title_full_unstemmed Metallic Stent Placement in Hemodialysis Graft Patients after Insufficient Balloon Dilation
title_short Metallic Stent Placement in Hemodialysis Graft Patients after Insufficient Balloon Dilation
title_sort metallic stent placement in hemodialysis graft patients after insufficient balloon dilation
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2667584/
https://www.ncbi.nlm.nih.gov/pubmed/16799272
http://dx.doi.org/10.3348/kjr.2006.7.2.118
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